Pharmacy Reimbursement Specialist — Patient Access

Rx Connect Specialty Pharmacy

Burlington

Hybrid

CAD 45,000 - 60,000

Full time

14 days+

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Benefits offered by this job

Competitive compensation package

Paid vacation, sick, wellness days

Weekday daytime schedule

Free on-site parking

Team environment

Work-life balance

Job summary

Rx Connect Specialty Pharmacy in Mississauga is seeking a Pharmacy Assistant with reimbursement experience to help patients navigate insurance coverage and access affordable medications. The role emphasizes reliability, organization, and excellent customer service, with familiarity in Kroll Pharmacy Management Software and adjudication troubleshooting with public and private payers.

Reporting to the Reimbursement Team Lead, you will verify coverage, gather information, process paperwork, and

Qualifications

Two or more years of reimbursement navigation experience involving private and public payers is required.
Two or more years of related pharmacy experience is an asset.
Experience with Patient Support Programs is an asset.
Experience with the Kroll Pharmacy Management System is an asset.
Familiarity with the Special Authorization process for both public and private insurance in assigned territory.
Proficiency in Microsoft Office Applications (Outlook, Word, Excel).
Commitment to high professional ethical standards and a diverse workplace.
Ability to work in a team environment and independently.

Responsibilities

Communicate with patients, prescribers, healthcare professionals and other key players to support patients through their treatment journey.
Verify and investigate insurance coverage and benefits for patients, including eligibility, co-payments, deductibles, and prior authorizations.
Gather and document information from patients/caregivers/prescribers in a concise, organized, and professional manner.
Complete, submit and follow-up on requisite paperwork on time.
Liaise with private and public insurance providers to determine coverage options.
Act as a central liaison for physicians, nurses, patients, and clinics and provide required updates.
Maintain confidentiality of patient healthcare information.
Keep up to date with changes in insurance coverage and reimbursement policies and communicate these changes to healthcare providers and patients.
Monitor treatments as well as chart and report on all activities directed by Physician protocols.
Provide patient education based on protocols, individually or in groups
Regular, predictable availability to meet appointment scheduling needs efficiently and cost-effectively to provide patients with quick access to necessary therapies.
Majority of the time, the role will be dedicated towards Reimbursement services
The Reimbursement Associate will also be assigned other duties and tasks as required from time to time.